Are there any side effects in getting a bone marrow test?

Question

Hi doctor,

My mother's age is 60 years, and six months back her WBC count was 26000. She got admitted for two days and was discharged, at that time her WBC count came to 9000. Now from the last month, she was feeling tired, so we checked the WBC count, and it was 14,000. We went to the general physician, who gave her antibiotics for a week, but again after a week, her WBC was same. The doctor told us not to take any medicines, and to wait for ten days. But, after ten days, her WBC count is up to 15,000. So, the doctor has suggested seeing a hematologist. I am worried about this situation. What can be the reasons for this? I am also attaching her latest reports. Is it necessary to do bone marrow test? Is there any side effects?

Answer 1

Hi,

Welcome to icliniq.com.

I have seen your attached reports (attachment removed to protect patient identity).

The report shows high total count and premature WBC cells up to 13 to 14 %. It seems to be a leukemoid reaction like condition. Myeloid proliferation is present, but it does not seem to be myeloid leukemia.
The liver, spleen and lymph nodes should be palpated. Usually, in CML (chronic myeloid leukemia), which can occur in old age, the WBC count is above 50000, and the liver, spleen and lymph nodes are palpable. Clinical correlation is strongly needed here. If liver, spleen or lymph node are palpable, then BCR/ABL t (9;22) can be done by PCR (polymerase chain reaction) testing, to check for chronic myeloid leukemia.
What was her complaint before six months? Apart from tiredness, was there any other clinical complaint?
Bacterial infection, hemorrhage, tissue necrosis, myocardial infarction, metabolic disorders, etc., are other causes. So, blood culture, EKG (electrocardiography), etc., investigations should be done.
If no specific cause is found after clinical correlation and if the count is not coming down, then bone marrow aspiration can be done. It does not have much side effects, but the coagulation profile needs to be checked before doing bone marrow aspiration.

Consult a nearby hematologist for examination with keeping all this in mind.